Tuesday, May 24, 2011

This Is An Old One...

I have seen this post several times and it still angers me. Since there is no way to rebut the Versed-loving anesthesiologist on the site itself, I am going to reproduce the statements here and say my piece! Here's the link; Anesthesiology: colonoscopy without midazolam (brand name: Versed), dr levy, roller coasters

Here's the text from the link. I am adding my own thoughts in a different color and any bold or italicized text is also mine.

Dr. Levy, in your response to a recent question entitled "Colon scope without versed" (asked on 6/15/2009), you indicated that you agree with the asker's GI doctor's statement that "most [...] Versed horror stories are untrue." You then went on to say that "[t]he majority of Versed complaints have to do with the amnestic effect of the drug. A lot of patients don't like the feeling of not remembering what happened. The fact is, this is an expected (AND desirable) effect of the drug." Having read this response of yours, I have two related questions for you. First, on what basis did you form your opinion that most Versed "horror stories" are untrue? I think if anything smacks of "untrue," it is the peculiar and seemingly reflexive (and, by the way, weak) defense, routinely issued by medical practitioners like yourself, of a drug that many people clearly abhor and that has caused intense, ongoing suffering in many patients. My second question is, exactly how can you characterize as "fact," the idea that amnesia is a "desirable" effect of Versed? You said yourself (see above quote) that "many patients don't like the feeling of not remembering what happened." Well, if that is indeed how "many" patients feel, then how could you possibly characterize the very thing they "don't like" as being "desirable" in any way? Could you instead mean, for example, that the inducement of amnesia in patients is "desirable" to YOU as the anesthesiologist? Alternately stated, to whom is amnesia desirable? Your very own words indicated that many patients don't like it. How, then, is it desirable? Please clarify.

Get the answer below

Let me start with the second question first. When Versed was developed, it was designed to relieve anxiety, be shorter acting than Valium and to cause amnesia. (emphasis mine)(Isn't it interesting that the amnesia isn't mentioned to the patient? And the drug was NOT designed to cause amnesia! If you will look around the web, this amnesia was a shock to anesthesia providers when Versed was first released. It was a "bug" not a design trait.) To use an analogy, one of the desired effects of roller coasters is to give an adrenalin rush to the rider. Because many people don't like that feeling, does that mean that we shouldn't make roller coasters?? (People who don't like an adrenalin rush can CHOOSE not to ride a roller coaster can't they? What a lame analogy! Or are you trying to say that anesthesia is a fun ride, just like at an amusement park? This sounds like drug seeking behavior if that is what you are saying. Isn't that something that physicians et al are very concerned with? People who look upon mind melting drugs as a fun ride, like a roller coaster?) Or to reverse what you're saying, Just because some people don't like the amnestic effects of Versed, should we withdraw the drug from those patients (the majority) (Majority? Says who?) who do want that effect? The fact of the matter is that Versed is given 10s of thousands of times every day (overuse and abuse of Versed) and perhaps less than 1% of patients don't like the effects. (Show me the scientific studies which prove that it's only 1%!) As an anesthesiologist, it is not desirable to ME for the patient to be amnestic other than as benefits the patient. (Balderdash! If this statement were true, this Dr. wouldn't be so absolutely DETERMINED to marginalize people who hate Versed.) Our role is to make the procedure as pleasant for the patient as possible, and for most people who have a fear of pain, fear of surgery and fear of bad outcome, not remembering their time in the OR is desirable. (Assumes facts not in evidence) As to the first question, it follows from my first answer. The only "horror" stories I've heard are related to amnesia which, as I said, occurs in less than 1%. ( The first part of this statement is a bald faced LIE! I myself wrote to this Dr. YEARS AGO complaining about Versed. I DIDN'T GET AMNESIA! He is either lying or selectively remembering, when he says that the only horror stories he has heard are about the amnesia. As for the second part, again, show me the PROOF that it's only 1% of patients. If you look around the web, it's a whole lot more than 1% who object to this drug. So the second part of this statement is also a fabrication.) You quote that many people have "intense, ongoing suffering"...what is the evidence for this statement. ( I am the evidence for this statement along with many, many others like me. Show me evidence to the contrary.) What exactly is the "ongoing" suffering?? (It's called PTSD, along with a myriad of other drug induced anxiety reactions stemming from the amygdalla. Insomnia, depression, anxiety, obsession, irritability, continuing memory issues etc. Don't act stupid Dr.) People may not (MAY not?) (We are telling you that we DO not like it! Besides, isn't this just what you say that 99% of patients desperately want? I'm confused, must be the Versed I was poisoned with!) like the feeling of lost memory, (exactly what you say we do like???) but I don't know of any reports in the literature discussing long term psychological effects from Versed administration. (That's because MEDICAL STAFF love this drug. There won't be any studies until we patients make enough noise to FORCE the medical community to seriously look at the side effects of their very favorite drug!)

So in summary, if you are one of those people that wants to remember all the fine details of your procedure, tell your anesthesiologist not to use an amnestic (and they won't), (Yes Dr. they will use an amnestic regardless of patient instructions. Many people report having this drug forced on them, to include myself, my sister, and many others.) but don't deny to people who don't want to remember, the right to have Versed. (This last statement is nothing but hyperbole. We are not trying "to deny to people who don't want to remember, the right to have Versed!" Don't try to obfuscate the true issue which is; We patients have a right NOT TO HAVE THIS DRUG VERSED. This is the crux of the matter. Patients are getting this drug whether they want it or not and without informed consent. It is causing them HARM! We want this ABUSE OF PATIENTS TO STOP!)

Hope this clarifies the situation,

Ronald Levy, MD
Professor of Anesthesiology

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